ANNETTE SILVIAPhD PUBLIC HEALTH, EPIDEMIOLOGY

WALDEN UNIVERSITYPUBH 8165–2

DR. FREDERICK GRANTSUMMER QUARTER, 2013

Introduction to Foodborne Illness and Food Safety

Food for Thought for Those in Culinary Arts

Learning Objectives for Students in Culinary Arts and/or Science

Expected learning outcomes

What you should know

Why you should care

AGENDA

Culinary Arts and Science

Foodborne illness by the numbersEvidence that may something may bug you when you eatWhat doesn’t kill you may not make you strongerSymptoms of foodborne illnessSources to consider in an outbreakNew food sources in the mixFarm to table food supply chainBreak the cycle with safe food handlingPublic Health ChallengesQ & A

Food has a way of “bugging” you

According to the Centers for Disease Control and Prevention (CDC) 2011 estimates:

1 in 6 Americans get sick each year from contaminated food (approximately 48 million people)

128,000 people are hospitalized3,000 die from foodborne illness31 known pathogens

Source: Centers for Disease Control and Prevention (CDC). (2011). CDC Estimates of Foodborne Illness in the United States.

United States 2011 Estimates for Foodborne Illness

Foodborne Agents

Estimated annual

number of illnesses

(90% credible interval)

%

Estimated annual number

of hospitalizations (90% credible

interval)

%

Estimated annual

number of deaths

(90% credible interval)

%

31 known pathogens

9.4 million (6.6–12.7 million)

2055,961

(39,534–75,741)44

1,351 (712–2,268)

44

Unspecified agents

38.4 million(19.8–61.2

million)80

71,878 (9,924–157,340)

561,686

(369–3,338)56

Total47.8 million (28.7–71.1

million)100

127,839(62,529–215,562)

1003,037

(1,492–4,983)100

Source: Centers for Disease Control and Prevention (CDC). (2011). CDC Estimates of Foodborne Illness in the United States.

Estimated Number of Illnesses by Pathogen

Estimated Number of Illnesses by Pathogen

Estimated Hospitalizations and Deaths by Pathogen

Estimated Hospitalizations and Deaths by Pathogen

Pathogen Estimated illnesses

Norovirus 5,461,731 (58%)

Salmonella, nontyphoidal 1,027,561 (11%)

Clostridium perfringens 965,958 (10%)

Campylobacter spp. 845,024 (9%)

Staphylococcus aureus 241,148 (3%)

PathogenEstimated

hospitalizationsEstimated deaths

Salmonella, nontyphoidal

19,336 (35%) 378 (28%)

Norovirus 14,663 (26%) 149 (11%)

Campylobacter spp. 8,463 (15%) 76 (6%)

Toxoplasma gondii 4,428 (8%) 327 (24%)

E.coli (STEC) O157 2,138 (4%)

Listeria monocytogenes

255 (19%)

Top Five Foodborne Pathogens

Source: Centers for Disease Control and Prevention (CDC). (2011). CDC Estimates of Foodborne Illness in the United States

Worth a Thousand Words

Source: www.nature.com

Campylobacter species

Worth a Thousand Words

Source: www.smartkitchen.com

Clostridium perfringens•Thoroughly cook foods to a safe internal temperature (especially meat, poultry, sauces)

•Use a food thermometer

•Keep food hot after cooking (≥140˚)

•Microwave reheated food thoroughly (to ≥165˚)

•Refrigerate foods within two hours (≤40˚)

•Divide leftovers into shallow containers and refrigerate immediately.

Do not let them cool on the counter.

Worth a Thousand Words

Source: www.healthhype.com

Escherichia coli (E. coli)

Worth a Thousand Words

Source: healthwise-everythinghealth.blogspot.com

Listeria monocytogenes

Worth a Thousand Words

Source: www.fehd.gov.hk

Campylobacter

Worth a Thousand Words

Source: www.foodpoisonjournal.com

Worth a Thousand Words

Source: http://www.webmd.com/food-recipes/food-poisoning/tc/staph-food-poisoning-topic-overview

Meats

Poultry and egg productsSalads such as egg,

tuna, chicken, potato, and macaroni

Bakery products such as cream-filled pastries,

cream pies, and chocolate eclairs

Sandwich fillings

Milk and dairy products

Staphylococcus aureus

Worth a Thousand Words

Source: http://www.dpd.cdc.gov/dpdx/HTML/Toxoplasmosis.htm

Toxoplasma gondii

Symptoms of Foodborne Illness

DiarrheaAbdominal crampsVomitingFeverWhen severe, these can lead to DehydrationLightheadedness/faintingOrgan failureDeath

Foods Evaluated in an Outbreak

New Sources of Illness (2006-2011)

Source: PulseNet, OutbreakNet, Foodborne Disease Outbreak Surveillance SystemSource: PulseNet, OutbreakNet, Foodborne Disease Outbreak Surveillance System

Food Supply Chain – Farm to Table

Point of origin (farm, sea, land)ManufactureDistributionPacking/ProcessingMarket (point of sale)Kitchen preparation

Where do you think contamination comes from?

Breaking the Cycle with Safe Food Handling

Food Supply Chain Prevention

Point of origin (farm, sea, land)

Preventative controls, clean handling, clean housing, use of reputable sources, temperature controls, routine testing, inspections

Manufacture Clean facilities, avoid cross contamination (raw/contaminated food), proper handling, inspections

Distribution/Transport Clean facilities and transport trucks, monitor for proper storage temperatures, track transports and storage conditions

Packing/Processing Reduce entry of contamination from source as well as process, clean facilities, proper handling, quality checks, inspections

Market (point of sale) Clean market space and display cases, proper handling and storage on shelf, prevent cross contamination

Kitchen preparation Cook food properly, disinfect surfaces, clean raw foods prior to eating, know your source

Public Health Challenges

Ensuring food safety from farm to tableEducating the public about safe food handling

practicesEducating food handlers about proper

handling and storageAssure health and safety of public by ensuring

regulations are followed, recalls as neededTrack outbreaks to identify source as quickly

as possible to limit spread

Other thoughts…?

Q & A

Don’t let what you eat end up bugging youThink about what you should and shouldn’t do

Make sure that you choose your food with care Know how to handle it and safely prepare

Eat a variety of fresh foods each dayLess worry now that you’ve learned the safe

way!

Thank you for allowing me the timeTo share with you (and attempt to rhyme).

References

Centers for Disease Control and Prevention (CDC). (2011). CDC Estimates of Foodborne Illness in the United States. Retrieved from http://www.cdc.gov/foodborneburden/2011-foodborne-estimates.html

Painter, J. A., Ayers, T., Woodruff, R., Blanton, E.,, Perez, N., Hoeksstra, R., Griffin, P. M., & Braden, C. (2009). Recipes for foodborne outbreaks: a scheme for categorizing and grouping implicated foods. Foodborne Pathogens and Disease, 6, 259-264.

Young, K. T., Davis, L. M., & DiRita, V. J. (2007) Campylobacter jejuni: molecular biology and pathogenesis. Nature Reviews Microbiology 5, 665-679 doi:10.1038/nrmicro1718

http://www.dpd.cdc.gov/dpdx/HTML/Toxoplasmosis.htm www.foodpoisonjournal.com

http://www.foodsafety.gov/poisoning/causes/bacteriaviruses/cperfringens/

www.healthhype.com

healthwise-everythinghealth.blogspot.com

www.fehd.gov.hk

www.nature.com

PulseNet, OutbreakNet, Foodborne Disease Outbreak Surveillance System Retrieved from http://www.cdc.gov/outbreaknet/

www.smartkitchen.com

http://www.webmd.com/food-recipes/food-poisoning/tc/staph-food-poisoning-topic-overview

Additional Resources

Centers for Disease Control and Prevention (CDC) Food Safety http://www.cdc.gov/foodsafety/

Keep Food Safe http://www.foodsafety.gov/keep/index.html

U. S. Food and Drug Administration (FDA) http://www.fda.gov/Food/

FoodborneIllnessContaminants/default.htmWebMD Food Poisoning Health Center

http://www.webmd.com/food-recipes/food-poisoning/default.htm